PURPOSE: The clinical significance of preoperative serum levels of CEA and CA19-9, levels of CEA and CA19-9 in peritoneal washing fluid and free cancer cells in peritoneal washing fluid in gastric cancer patients were evaluated in this study. MATERIALS AND METHODS: Serum and peritoneal levels of CEA and CA19-9 and peritoneal washing cytology in 115 patients with gastric cancer were analyzed with respect to the prognostic factors using univariate and multivariate analysis. RESULTS: Positive rate of serum CEA and CA19-9 was 16.5%, 13.0%. And that of peritoneal washing CEA, CA19-9 and cytology was 15.7%, 7.8% and 9.6%. A univariate analysis showed that tumor markets in serum and peritoneal washing fluid and peritoneal washing cytology had significant correlations with the progression of the tumors, and patients with positive serum or peritoneal tumor markers had poorer survival after operation than did the patients with negative tumor markers. But in a multivariate analysis showed that only peritoneal CA19-9 was an independent risk factor. And combination of these five markers provided rnore predictable prognostic informations in a multivariate analysis. CONCLUSION: Combination of serum or peritoneal levels of CEA, CA19-9 and washing cytology appeared to be a useful marker for managing gastric cancer patients.
Humans ; Multivariate Analysis ; Risk Factors ; Stomach Neoplasms ; Biomarkers, Tumor

Neurolymphomatosis is rare neurologic manifestation, that usually develops in patients with wide spread non-Hodgkin's lymphoma. Cranial neuropathy is an unusual syndrome of neurolymphomatosis that is sometimes difficult to diagnose using conventional imaging modalities. We report a 63 year-old man with non-Hodgkin's lymphoma with progressive multiple cranial nerve palsy. He complained progressive cranial nerve palsy. We performed conventional magnetic resonance imaging and cerebrospinal fluid(CSF) exam. But no any abnormality showed in conventional imaging and CSF study. We report a patient who presented with cranial neuropathy in neurolymphomatosis.
Animals ; Cranial Nerve Diseases ; Cranial Nerves* ; Humans ; Lymphoma, Non-Hodgkin ; Magnetic Resonance Imaging ; Marek Disease* ; Middle Aged ; Neurologic Manifestations

We have been using general anesthesia with thoracic epidural anesthesia to manage intrao-perative and postoperative pain for thoracic and cardiac surgery patients. Hemodynamic changes due to sympathetic block with epidural anesthesia is dependent on the level of sympathetic block. Thoracic epidural anesthesia block the cardiac sympathetic innervation, so there may be changes of cardiac function and pressure dependent coronary blood flow especially in coronary artery diseases. To investigate the effects of thoracic epidural anesthesia on coronary blood flow and hemodynamic changes, we performed thoracic epidural anesthesia by injection of 0.5% bupivacaine via a surgieally introduced catheter in dogs. The results were as follows ; 1) Coronary blood flow, systolic, mean and diastolic blood pressure, heart rate and cardiac output were decreased at 5 min, 10 min, 15 min, 20 min, 30 min, 45 min, 60 min, 90 min, 120 min after epidural injection of 0.5% bupivaeaine compared to control value (p<0.05). 2) Systemie vascular resistance, central venous pressure, pulmonary artery pressure, pulmonary capillary wedge pressure, stroke volume and pulmonary vascular resistance were not changed after epidural injection of 0.5% bupivacaine.
Anesthesia, Epidural* ; Anesthesia, General ; Animals ; Blood Pressure ; Bupivacaine ; Cardiac Output ; Cardiovascular System* ; Catheters ; Central Venous Pressure ; Coronary Artery Disease ; Dogs* ; Heart Rate ; Hemodynamics ; Humans ; Injections, Epidural ; Pain, Postoperative ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Stroke Volume ; Thoracic Surgery ; Vascular Resistance

The usefulness of a nondepolarizing muscle relaxant for endotracheal intubation is limited by its relatively slow onset of neuromuscular block compared to that achieved with succinylcholine. Several attempts have been made to produce a more rapid onset of muscle relaxation for endotracheal intubation. A large dose of nondepoarizing muscle relaxant may produce rapid onset but cauae undesirable side effects and a prolonged duration of neuromuscular block. The authors observed the degree of vocal cord relaxation and intubation condition 2 minutes after administration of atracurium and measured changes in mean arterial blood pressure and heart rate at the time of arrival in the operating room, just before abministration of atracurium, 2minutes after administration, and 5mins after intubation. The 40 of patients in this observation were divided into four groups. Group 1; 10patients, received 0.3 mg/kg of atracurium Group 2; 10patients, received 0.4 mg/kg of atracurium Group 3; 10patients, received 0.5 mg/kg of atracurium Group 4; 10patients, received 0.6 mg/kg of atracurium The results were as follows; 1) There were better intubating conditions in Group 3 and 4 than in Group 1 and 2(p<0.001). 2) Mean arterial blood pressure and heart rate did not change significantly after administration of atracurium in all four groups. From the above results we conclude that 0.5~0.6 mg/kg of atracurium provides satisfactory intubation condition 2 minutes after administration without hemodynamic changes.
Arterial Pressure ; Atracurium* ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Intubation, Intratracheal* ; Muscle Relaxation ; Neuromuscular Blockade ; Operating Rooms ; Relaxation ; Succinylcholine ; Vocal Cords

Nosocomial infection represent a significant cause of patient morbidity and mortality, especially in the ICU and nosocomial pneumonia that cause high mortality may arise from contaminated respiratory equipments. This study was done to investigate the relationship of micro-organisms in upper respiratory tract and ventilatory equipment, especially humidifier. The total number of cases in this study was 20 and the specimen for bacteriologic culture were taken from the pharynx, the distilled water and the inner wall of humidifier and toilet of trachea at the 0, 4, 8, 12, 24, 48 hours after initiation of mechanical ventilation. The results obtained from the bacteriologic culture were as follows. 1) The most frequently found organism at the pharynx was Pseudomonas aeruginosa and next was Coagulase Negative Staphylococcus, followed by Streptococcus viridans, Klebsiella pneumoniae, Staphylococcus aureus, Streptococcus group D, Enterobacter agglomerans, Acinetobacter spp. 2) The most frequently found organism at the trachea was Pseudomonas aeruginosa and next was Klebsiella pneumoniae followed by Coagulase Negative Staphylococcus, Streptocoecus viridans, Pseudomonas picketti, Staphylococcus aureus and no growth in 5 cases. 3) The most frequently found organism in the fluid of humidifier was Pseudomonas aeruginosa and next was Pseudomonas picketti, Klebsiella pneumoniae, Streptococcus group D and no growth in 2 cases. 4) The most frequently found organism at the pharynx was Pseudomonas aeruginosa and next was Pseudomonas picketti, Klebsiella pneumoniae, Streptococcus group D, Serratia liquefacines, Acinetobacter spp and no growth in 3 cases. 5) The number of isolated organisms in the fluid of humidifier was 3 at 0 hour and 18 after 48 hours and at the wall 2 at 0 hour and 15 after 48 hours. 6) The number of same organism that was isolated between the pharynx and trachea was 13 among 15 cases and between the wall and fluid of humidifier was 15 among 16 cases and between trachea and fluid of humidifier was 10 among 14 cases.
Acinetobacter ; Coagulase ; Cross Infection ; Enterobacter ; Enterococcus faecalis ; Humans ; Klebsiella pneumoniae ; Mortality ; Pharynx ; Pneumonia ; Pseudomonas ; Pseudomonas aeruginosa ; Respiration, Artificial ; Respiratory System ; Serratia ; Staphylococcus ; Staphylococcus aureus ; Trachea ; Ventilators, Mechanical* ; Viridans Streptococci ; Water

Pheochromocytoma is functioning tumor which originates in the adrenal medulla or in chromaffin tissue along the paravertebral sympathetic chain. This tumor releases epinephrine and norepinephrine causing increase of peripheral resistance and resulting in increased blood pressure and reducing plasma volume. The anesthetic management of patients with pheochromocytoma presents many difficult problems such as hypertension, cardiac arrhythmias, and hypotension. A 40 year-old female underwent resection of pheochromocytoma under general anesthesia. Thiopental was used for induction followed N2O-O2-enflurane supplemented with fractional doses of fentanyl and vecuronium for muscle relaxation. Hypertensive crisis during induction of anesthesia and surgical manipulation of the tumor were managed with phentolamine and sodium nitroprusside, and premature ventricular beats were controlled with lidocaine. We experienced marked fluctuation of blood pressure during anesthetic course.
Adrenal Medulla ; Adult ; Anesthesia ; Anesthesia, General ; Arrhythmias, Cardiac ; Blood Pressure ; Epinephrine ; Female ; Fentanyl ; Humans ; Hypertension ; Hypotension ; Lidocaine ; Muscle Relaxation ; Nitroprusside ; Norepinephrine ; Phentolamine ; Pheochromocytoma* ; Plasma Volume ; Thiopental ; Vascular Resistance ; Vecuronium Bromide ; Ventricular Premature Complexes

Nesidioblastosis is a rare disease characterized clinically by persistent hypoglycemia with inappropriately elevated circulating insulin concentration. Adequate early diagnosis should be established and subtotal pancreatectomy performed before itreversible cerebral damage caused by glucose deficit. The authors got a chance to anesthetize 56-day-old male patient for subtotal pancreatectomy because of nesidioblastosis, Following an induction of anesthesia with intravenous thiapental sodium 5 mg/kg and succinylchohne 1 mg/kg, endotracheal intubation was performed and anesthesia was maintained with pancuronium bromide and O2-N2O-enflurane. Intravenous fluid was maintained with 1-2-3 solution 30 ml and 15% D/W 40 ml mixed with 20 ml of 20 mEq/L NaCI.
Anesthesia* ; Early Diagnosis ; Glucose ; Humans ; Hypoglycemia ; Insulin ; Intubation, Intratracheal ; Male ; Nesidioblastosis* ; Pancreatectomy* ; Pancuronium ; Rare Diseases ; Sodium

No abstract available.
Blood Pressure Monitors* ; Blood Pressure* ; Fingers*

No abstract available.
Humans ; Intensive Care Units* ; Critical Care* ; Korea*

No abstract available.
Anesthesia* ; Emergencies*